A framework for administrative claim data to explore healthcare coordination and collaboration.

Previous studies have documented the application of electronic health insurance claim data for health services research purposes. In addition to administrative and billing details of healthcare services, insurance data reveal important information regarding professional interactions and/or links that emerge among healthcare service providers through, for example, informal knowledge sharing. By using details of such professional interactions and social network analysis methods, the aim of the present study was to develop a research framework to explore health care coordination and collaboration. The proposed framework was used to analyse a patient-centric care coordination network and a physician collaboration network. The usefulness of this framework and its applications in exploring collaborative efforts of different healthcare professionals and service providers is discussed.